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Plate fixation in challenging traumatic carpal scaphoid lesions
A Leti Acciaro1, D Lana2, A Fagetti3
1C.S. of Hand Surgery and Microsurgery, AOU Policlinico of Modena, Largo del Pozzo 71, 41125, Modena, Italy.
Musculoskeletal Surgery
|January 4, 2021
Summary
Volar locked plating effectively treats complex scaphoid fractures and non-unions. This technique offers good stability and bone healing for challenging carpal scaphoid injuries.
Area of Science:
- Orthopedic surgery
- Hand surgery
- Traumatology
Background:
- Complex carpal scaphoid fractures with fragmentation, comminution, bone loss, and non-unions present significant surgical challenges.
- Previous screw fixation failures in scaphoid fractures necessitate advanced treatment modalities.
Purpose of the Study:
- To evaluate the indications, advantages, and outcomes of scaphoid plating for complex carpal scaphoid fractures.
- To highlight the critical role of precise plate positioning in scaphoid plating procedures.
Main Methods:
- A cohort of 11 patients with acute complex scaphoid fractures and non-unions post-screw fixation were treated.
- Volar locked plate fixation was employed, with cortical bone grafting utilized for non-union cases.
Main Results:
- Complete bone consolidation was achieved in all treated scaphoid fractures.
- The non-union group demonstrated excellent fracture healing and significant symptom/functional improvement.
- One patient required early revision surgery (first row carpectomy) with suboptimal outcomes.
Conclusions:
- Volar locked plate fixation is an effective technique for managing selected complex carpal scaphoid lesions.
- The technique allows for anatomical contouring, adequate deformity correction, and high stability in both acute fractures and non-unions.
